Therapists are having to ‘‘pick up the pieces’’ for the adult survivors of childhood sexual abuse because they are not getting the help they need from ACC, a leading psychotherapist says.

New Zealand Association of Psychotherapists spokesman Kyle MacDonald said progress made by ACC since changes to the way they handle sensitive claims were brought in has been too slow in coming.

‘‘It’s fair to say there have improvements but it’s nowhere near enough. They’ve had 18 months to put these systems in place now.’’

Dr Barbara Disley yesterday released the second monitoring report of ACC’s progress on the development and implementation of 14 recommendations given by a 2010 Sensitive Claims Clinical Pathway review.

She said there were concerns within the sector over the processes around independent assessment for cover.

‘‘While there have been improvements, including the ability of the support counsellor to attend these assessments with the client, the narrow range of tools applied to determining mental injury and the limited number of professional groups who can administer these tools leads to bottle necks and delays in cover determination,’’ she said.

‘‘ACC needs to urgently review the assessment processes within the adult claims coverage context and broaden the range of tools and professional groups capable of undertaking these assessments.’’

Dr Disley said it was particularly important for adult survivors of child sexual abuse as the needs of the group were often complex and required specialist knowledge.

‘‘A specific focus on the needs of this group needs to be now initiated,’’ she said.

The number of clients that moved through the cover assessment process was low, falling dramatically from 5919 in 2007 to 235 last year.

Dr MacDonald said that was a ‘‘horrible number’’.

“This is clear evidence that the ACC’s policies are still failing New Zealanders and survivors of sexual abuse. And it’s worth remembering this report pre-dates the privacy breach of over 6000 ACC claimants, and subsequent events.”

Dr MacDonald, who sits on the Sensitive Claims Advisory Group, which ACC regularly meets, said the low number of successful claims was a direct result of the changes.

‘‘This report demonstrates how victims of sexual abuse and assault are still struggling to access the support they are entitled to as a direct result of the National Government-led cost cutting drive in 2009. The fallout of this ill-informed policy is still being felt.’’

Among the changes that resulted four months later was a rule that new claimants and people waiting for a decision on whether they qualified for treatment could get 16 hours ‘‘initial support’’. These 16 free sessions have to be undertaken by an independent, but ACC appointed, assessor.

‘‘The idea of going to talk to a complete stranger is sometimes one of the worst thoughts imaginable for our clients, and they have to go in there and open up to someone they barely know about some of the most traumatic experiences from their past,’’ Dr MacDonald said.

He said clients were simply choosing not to go through with it.

‘‘I think it was probably something that many psychotherapists and clinicians were expecting when the changes came into play. We’re essentially trying to pick up the pieces from an idea that was theirs in the first place.’’

The report said ACC urgently needed to review its assessment process for adult survivors of childhood sexual abuse with mental injury.

In the report, Dr Disley also said Maori must be given priority as progress in that area had been slower than expected.

However, the process for children and adolescents in relation to accessing immediate support and moving through the cover process had improved.

Overall, Dr Disley found ACC had made ‘‘excellent progress’’ implementing one recommendation and good progress on another six.

‘‘There’s still work to be done in some areas,’’ she said.

Greens ACC spokesman Kevin Hague said the Government and ACC had created a culture of ‘‘severe disentitlement’’ when it came to sensitive claims.

ACC was purposely making it harder for clients to get their claims accepted following evidence released by the Greens showing ACC staff were paid bonuses for cutting claimants from the ACC books, he said.

ACC Minister Judith Collins said there had been progress on all but one recommendation but there was still more work for ACC to do.

‘‘Obviously not everything that has been recommended has been completed to the level it should have been. I expect most of them will be completed in the next 18 months.’’

ACC was undertaking major changes in the area of sensitive claims, 范she said.

‘‘Ultimately they have to make sure they make those changes sustainably and right through the organisation.’’

The 2010 review, requested by then ACC Minister Nick Smith, made 14 recommendations, including that a process be established to independently monitor the development and implement the review’s suggestions.